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Complex Care > COPD > Flashcards

COPD Flashcards

1
Q

Emphysema

A

characterized by the irreversible damage to the air sacs in the lungs, leading to their enlargement and reduced elasticity thus making exhalation difficult

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2
Q

Chronic Bronchitis

A

a persistent inflammation of the bronchial tubes, which carry air to and from the lungs

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3
Q

Effects of smoking on COPD

A

Most common cause

    • Stimulates sympathetic nervous system: HR, BP (vasoconstriction), increase in cardiac workload
    • Nicotine: decreases amount of functional HgB, increase platelet aggregation, and further complicates coronary artery disease
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4
Q

Bullae

A

air spaces in the parenchyma

Take away gas exchange site – takes away functional tissue

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5
Q

Blebs

A

air spaces adjacent to parenchyma

Take away gas exchange site – takes away functional tissue

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6
Q

Clinical Manifestations of COPD

A
  1. Dyspnea
  2. Chest breathing
  3. Respiratory Acidosis
  4. Prolonged expiratory phase
  5. Wheeze
  6. Decreased breath sounds
  7. Bluish-red color of skin
  8. Underweight
  9. Fatigue
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7
Q

5 Complications of COPD

A
  1. Cor Pulmonale
  2. Exacerbations
  3. Acute Respiratory Failure
  4. Peptic Ulcer Disease
  5. Depression Anxiety
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8
Q

Explain pathophysiology of cor pulmonale

A
  • hypoxia, acidosis, and hypecapnia are present in COPD
  • this leads to polycythemia (increasing blood’s viscosity) and pulmonary vasoconstriction
  • this causes pulmonary hypertension, making it difficult for the RV to pump blood through the pulmonary system
  • this leads to RV hypertrophy and this RS HF
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9
Q

Define COPD Exacerbation

A

A sustained worsening of dyspnea, cough or sputum production leading to an increase in the use of maintenance medications and/ or supplementation with additional medications.

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10
Q

What are the signals that someone is experiencing a COPD exacerbation?

A

Change in usual
- dyspnea
-cough
-sputum

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11
Q

What triggers a COPD exacerbation?

A

Mainly infection !!
also pollutants

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12
Q

How are COPD exacerbations further classified?

A

Purulent vs non purulent

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13
Q

What causes acute respiratory failure?

A
  • Caused by
  • Exacerbations
  • Cor pulmonale
  • Discontinuing/changes to bronchodilator or corticosteroid medicatio
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14
Q

What confirms COPD diagnosis?

A

PFT

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15
Q

FEV 1

A

Measurement used in PFT

volume of air blown out as hard and fast as possible during the first second of the most forceful exhalation after the greatest full inhalation

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16
Q

FVC

A

functional vital capacity

total amount of air exhaled during the FEV test

17
Q

Normal ratio/PFT result

A

Ratio between FEV1 and FVC should be around 70-80

18
Q

PaO2 normal value

A

80-100

19
Q

PaCO2 normal value

A

35-45

20
Q

pH normal value

A

7.35-7.45

21
Q

HCO3 normal value

A
  • 22 to 26
22
Q

Normal COPD ABG results (PaO2, PaCO2, pH, bicarb)

A
  • Low PaO2
  • ↑ PaCO2
  • ↓ pH (the higher the CO2 the more acidic the blood is)
  • ↑ Bicarbonate level found in late stages of COPD
23
Q

Normal trigger vs COPD trigger to breath

A
  • Hypercapnia is normal trigger to breath
  • Hypoxia is COPD trigger to breath – cautious in turning off trigger
24
Q

How do you preserve the CO2 drive in COPD patients

A

titrate to lowest effective dosage needed for EACH pt

25
Q

Ventolin, Atrovent, Combivent are examples of

A

SABA

26
Q

SABA MOA

A

help relax the tight muscles around airways therefore opening them up and making it easier to breathe

27
Q

Flovent, Pulmicort, Spiriva, Advair, Symbicort are examples of

A

LABA and combination to CONTROL

28
Q

Controller COPD medications MOA

A
  • help prevent respiratory symptoms such as wheezing, coughing, and SOB
29
Q

Key points about nutrition for COPD

A
  • Patients prone to dyspepsia, dyspnea affects intake and tolerance of foods/ meals
  • High calorie, protein rich, small frequent meals
30
Q

Key points about fluids for COPD

A
  • High intake of fluids: 2-3 Liters/ day to loosen secretions

Complex Care (9 decks)

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